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血管加压素导致糖尿病中的超滤、蛋白尿和肾肥大:对血管加压素缺乏的布拉特洛维大鼠的研究。

Vasopressin contributes to hyperfiltration, albuminuria, and renal hypertrophy in diabetes mellitus: study in vasopressin-deficient Brattleboro rats.

作者信息

Bardoux P, Martin H, Ahloulay M, Schmitt F, Bouby N, Trinh-Trang-Tan M M, Bankir L

机构信息

Institut National de la Santé et de la Recherche Médicale, Unité 367, 17, Rue du Fer à Moulin 75005 Paris, France.

出版信息

Proc Natl Acad Sci U S A. 1999 Aug 31;96(18):10397-402. doi: 10.1073/pnas.96.18.10397.

Abstract

Diabetic nephropathy represents a major complication of diabetes mellitus (DM), and the origin of this complication is poorly understood. Vasopressin (VP), which is elevated in type I and type II DM, has been shown to increase glomerular filtration rate in normal rats and to contribute to progression of chronic renal failure in 5/6 nephrectomized rats. The present study was thus designed to evaluate whether VP contributes to the renal disorders of DM. Renal function was compared in Brattleboro rats with diabetes insipidus (DI) lacking VP and in normal Long-Evans (LE) rats, with or without streptozotocin-induced DM. Blood and urine were collected after 2 and 4 weeks of DM, and creatinine clearance, urinary glucose and albumin excretion, and kidney weight were measured. Plasma glucose increased 3-fold in DM rats of both strains, but glucose excretion was approximately 40% lower in DI-DM than in LE-DM, suggesting less intense metabolic disorders. Creatinine clearance increased significantly in LE-DM (P < 0.01) but failed to increase in DI-DM. Urinary albumin excretion more than doubled in LE-DM but rose by only 34% in DI-DM rats (P < 0.05). Kidney hypertrophy was also less intense in DI-DM than in LE-DM (P < 0.001). These results suggest that VP plays a critical role in diabetic hyperfiltration and albuminuria induced by DM. This hormone thus seems to be an additional risk factor for diabetic nephropathy and, thus, a potential target for prevention and/or therapeutic intervention.

摘要

糖尿病肾病是糖尿病(DM)的一种主要并发症,而这种并发症的发病机制尚不清楚。血管加压素(VP)在I型和II型糖尿病患者中水平升高,已被证明可增加正常大鼠的肾小球滤过率,并促进5/6肾切除大鼠慢性肾衰竭的进展。因此,本研究旨在评估VP是否会导致糖尿病的肾脏病变。对缺乏VP的尿崩症(DI)Brattleboro大鼠和正常的Long-Evans(LE)大鼠进行比较,这些大鼠有的患有链脲佐菌素诱导的糖尿病,有的未患糖尿病。糖尿病2周和4周后采集血液和尿液,测量肌酐清除率、尿糖和白蛋白排泄量以及肾脏重量。两种品系的糖尿病大鼠血浆葡萄糖均增加了3倍,但DI-DM大鼠的葡萄糖排泄量比LE-DM大鼠低约40%,这表明代谢紊乱程度较轻。LE-DM大鼠的肌酐清除率显著增加(P<0.01),而DI-DM大鼠的肌酐清除率未增加。LE-DM大鼠的尿白蛋白排泄量增加了一倍多,而DI-DM大鼠仅增加了34%(P<0.05)。DI-DM大鼠的肾脏肥大程度也低于LE-DM大鼠(P<0.001)。这些结果表明,VP在糖尿病诱导的高滤过和蛋白尿中起关键作用。因此,这种激素似乎是糖尿病肾病的另一个危险因素,从而是预防和/或治疗干预的潜在靶点。

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Vasopressin V1 and V2 receptors in diabetes mellitus.
Am J Physiol. 1994 Feb;266(2 Pt 1):E217-23. doi: 10.1152/ajpendo.1994.266.2.E217.
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